In Depth

Not only would federal health-care legislation significantly cost Indiana if passed, the state's Attorney General also
believes aspects of the legislation could be constitutionally questioned and possibly overturned by courts.

Indiana Attorney General Greg Zoeller issued a 55-page report today studying the constitutionality of the U.S. Senate-created
health-care bill and what its impact might be on Indiana. The in-house research and drafted report comes a month after some
of Indiana's congressional delegation asked the state agency to review provisions of the Patient Protection and Affordable
Care Act under Indiana Code 4-6-8-2 that allows this specific review if requested.

If the legislation is passed, the AG has determined that Indiana would bear substantial economic costs - roughly about $500,000
more added to the Medicaid rolls - and create unintended consequences for patients, taxpayers, and the state's medical-device
industry.

Legally, the report notes that some provisions could be struck down in a court challenge:

· The bill's "individual mandate" requiring everyone to buy health insurance or face a penalty would
be unprecedented; never before has the federal government required Americans to purchase any good or service, nor has it regulated
inactivity.

· The bill's "Nebraska Compromise" amendment would expand the number of Medicaid participants in all
states but fully fund the expansion for Nebraska only, while the other 49 states would have to absorb additional costs. While
courts are properly reluctant to second-guess legislative deal making, such disparate treatment of one state appears to violate
Article I of the U.S. Constitution, the report says.

· The bill would also require states to create insurance "exchanges" and require for-profit health insurers
to offer certain types of coverage, making private insurers essentially highly regulated entities similar to public utilities,
the report says. Before insurance exchanges are available, states would have to administer a temporary reinsurance program
for high-risk patients. That mandatory obligation on the part of state officials might be found unconstitutional, according
to the report.

While passed by the Senate Dec. 24, the health-care proposal remains pending in Congress and the Indiana Attorney General's
Office report is being offered for legislators to consider as that process continues.

Conversations

0 Comments

Post a comment to this story

We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or
hateful.

You are legally responsible for what you post and your anonymity is not guaranteed.

Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in Indiana Lawyer editorial content
are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.

No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are
relevant to the topic at hand, but please do not link to objectionable material.

We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag
a post simply because you disagree with it.